朱爱华　杨燕玲　刘春君　戴煌　王预建　徐状　慈书平

阻塞性睡眠呼吸暂停低通气综合征与高血压关系24年随访

朱爱华杨燕玲刘春君戴煌王预建徐状慈书平

【摘要】目的随访阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与高血压的关系。方法对1 868例人群进行前瞻性随访，通过家访式调查，随访期间每年进行1次体检，检查血压、血脂、血糖、心电图及X线胸片等，随访时间为24年。结果1 868例中男性956例、女性912例，随访起点年龄范围53～82岁，平均年龄(63±6)岁。其中确诊OSAHS者598(32.0%)例，无OSAHS(对照组)1 270(68.0%)例。随访终点OSAHS组高血压506(84.6%)例、对照组398(31.3%)例，P<0.01。结论OSAHS患者发生高血压可能性较一般人群高，考虑OSAHS与发生高血压存在相关性。通过24年随访，提示OSAHS可能是高血压病的独立危险因素。引起高血的机制可能与OSAHS导致的低氧血症等有关。

【关键词】睡眠呼吸暂停低通气综合征；阻塞性；高血压病；流行病学；随访

The correlation between obstructive sleep apnea hypopnea syndromeand and Hypertension

ZHU Aihua*，YANG Yanling，LIU Chunjun，DAI Huang，XU Zhuang，WANG Yujian，CI Shuping.*The 359th hospital of PLA，Department of Elderly Medicine，Zhenjiang 212001，China

Corresponding author：CI Shuping，E-mail：cishuping@sohu.com

【Abstract】ObjectiveTo explore the correlation between obstructive sleep hypopnea apnea syndrome(OSAHS)and hypertension.MethodsProspective Home-visit questionaires for 1 868 people were used from November 1989 to November 2013，accompanied by annual medical examinations including blood pressure，blood-fat，serum glucose，electrocardiogram and chest x-ray.Computer tomography was carried out When hypertension manifested,that was termination of follow-up，the period of follow-up lasted 24 years.ResultsAmong 1 868 elderly people，598(32.0%)OSAHS patients were made.1 270(68.0%)non-OSAHS group.patients who developed into hypertension were 506/598(84.6%)in OSAHS group，and 398/1 270(31.3%)，P<0.01)in non-OSAHS group，respectively.943 died at last in the course of 24 years，431/598(72.1%)in OSAHS group and 512/1 270(40.3%，P<0.01)in non-OSAHS group，respectively.ConclusionAccording to longtime follow-up，the probability of OSAHS patients suffers from hypertension is larger than the normal.We consider that there is a correlation between OSAHS and hypertension.At the end of our 24 years follow-up,OSAHS may be an independent dangerous factor of hypertension.

【Key Words】Sleep apnea hypopnea syndrome；Obstructive；Hypertension；Epidemiological survey；Follow-up

为了解阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与高血压的关系，自1989年11月至2013年11月，通过对所属13所军队和地方离退休干部休养所及部分地方的中老年人共1 868例进行OSAHS与高血压的24年随访研究。

1对象和方法

1.1对象1989年11月共入选患者1 868例，其中男性956例、女性912例，年龄53～82(63±6)岁。配偶夫妇903对。随访终点结束时生存925例，配偶夫妇436对，其中男性424例、女性501例。年龄77～103(83±7)岁。OSAHS组598例，对照组(无OSAHS组)1 270例。

1.2随访项目调查打鼾发生时间和程度、有无憋气现象、主要疾病及发生时间、临床症状、反应能力等98项。除观察高血压外，还包括其它疾病。每2年进行1次分析，随访时间为24年。

1.3调查方法采用家访式调查，通过向其配偶或家属询问有无OSAHS病史、年限及程度。调查人员有医院和干休所医生负责，并经培训后进行调查。收集的资料输入建立的专用数据库中。多导睡眠监测采用MONET32导睡眠监测仪(美国邦德安百医疗用品有限公司)。……